Neuroendocrine disorders

Learning
outcomes:

describe the basic structure and function of the
hypothalamic-pituitary axis and the hormones secreted by the
hypothalamus and pituitary gland

identify the aetiology, clinical features and treatment of mood
disorders which are related to the menstrual cycle and pregnancy
and distinguish between their presentations

outline the physiological role of thyroid hormones, the control
of their secretion and the causes, clinical features, investigation
and treatment of thyroid disease

describe the anatomy and secretory role of the adrenal gland,
control of adrenocortical hormone secretion and the aetiology,
clinical features, investigation and treatment of disorders caused
by their excessive and insufficient secretion

outline the function of the pineal gland and its role in sleep
disorder

identify the causes of gonadal hormone disorders and clinical
features of syndromes caused by gonadal dysgenesis

differentiate the aetiology of type 1 and type 2 diabetes,
outline the clinical features and know the basic management of the
two types

describe the mechanism of action of growth hormone and the
causes, diagnosis and outcomes of growth hormone secretion
deficiency.

Module introduction

Why is knowledge of the neuroendocrine system important for
psychiatrists?

Endocrinology and psychiatry have a close and complex
relationship. Endocrine disorders can affect a person’s mental
state well before the onset of physical signs of illness; for
example, depression occurs in people with hypothyroidism,
and Cushing’s syndrome typically manifests with various
neuropsychiatric features. Similarly, psychiatric disorders can be
accompanied by abnormalities of hormonal levels, such as
when blunted growth hormone response to provocative stimuli is
seen in depression (Checkley
et al, 1981).

Hormonal imbalances can be a side-effect of psychotropic drugs.
For example, people receiving lithium require close monitoring
of their thyroid function, and some endocrine disorders can be
precipitated by stressful life events such as Cushing’s syndrome
and Grave’s disease. These examples highlight the interface between
neuropsychiatry and endocrinology. It is important for us as
psychiatrists to have a good knowledge of the associations between
endocrine disorders and psychiatric illness so that we are able to
identify and manage them successfully.

This module will cover the neuroscience of common endocrine
disorders along with their psychiatric manifestations.

Learning notes

We recommend that you make some notes as you work through
this module.

The 'TrOn Notebook' facility can be accessed
throughout the module (allowing you to make notes on each page),
and these notes will be saved in your personal area 'My TrOn', for
future reference. However, you will not be able to print these
notes as one single document.

If you would prefer to make your notes in a
separate document you may wish to download the 'learning notes'
below. This downloadable Word document will allow you to keep a
personalised record of your learning, which you can then save
and/or print for future reference.